Now, parents, policymakers and healthcare providers are holding their breath as Congressional Republicans weigh on the potential billions of dollars in Medicaid cuts. The federal dollar pays more than half of MassHealth's $20 billion annual budget.
“It's the cornerstone of the health of children in Massachusetts,” said Katherine Howitt, director of the Massachusetts Medicaid Policy Institute, the Massachusetts Foundation's Blue Cross Blue Shield's independent policy analysis program.
The result of significant Medicaid cuts, and the likelihood of voter anger, will some suspicious legislatures eventually be reduced from public insurance programs.
Information coming out of Washington is too vague to act, said Mike Levine, assistant secretary at Mass Health.
“We don't have a specific contingency plan for the services we provide to our children and what Congress or CMS will do if we take actions that we dislike,” he said in an interview Monday.
Still, the possibility scares Bernard. When she was her daughter, Victoria was two years old, but her mother said she had multiple seizures a week before doctors could understand which prescriptions and doses would optimally control epilepsy. The child's speech is late, but when therapy MassHealth pays, she is learning to express herself verbally.
“Without MassHealth, I don't know how to do it,” Bernard said. “I'm very worried about that.”
Congressional Republicans say they hope to balance tax cuts by eliminating $880 billion in federal spending over a decade. Top Republicans, including President Trump, have said that cuts in Medicaid benefits are not included. US House Speaker Mike Johnson said his party is only looking for cuts “Fraud, waste, abuse.”
However, health policy experts They say Republicans can't reach their budget goals without affecting Medicaid. Over $600 billion a year, the program is one of the federal governments. The biggest cost.
“We know that the only way we can achieve a $880 billion reduction is through catastrophic reductions in the Medicaid program,” said Megan Cole Brahim, a professor at Boston University and co-director of the school's Medicaid Policy Institute. “There's really no way to make no meaning harmful to children.”
Massachusetts expanded MassHealth in 2006 to expand coverage to more children than a few states, including children in households that have achieved up to 300% of federal poverty levels.
As of 2023, only 0.6% of Massachusetts children were uninsured. Report From the State Center for Health Information Analysis on State Insurance.
A post-pandemic review of state MassHealth eligibility removed roughly 363,000 people from membership last year, including around 59,000 children under the age of 17, the state reported.
Even if Congress had a Medicaid hatch, Cole Brahim said he expects Massachusetts to protect their children from the brunt of the outcome. Authorities will be forced to reduce access to the benefits of several options, including physical therapy, case management, and community health workers, and can reduce the type of prescription drug, or the doses covered by MassHealth.
Losing even a partial Medicaid refund would be devastating to community health centers and hospitals. On average, health centers receive around 31% of their revenues from MassHealth, according to the Massachusetts Community Health Center league. MassHealth paid for it 18% Of all hospital revenues in the state as of 2022, according to the Massachusetts Foundation's Blue Cross Blue Shield. Boston Children's Hospital reports that approximately 46% of Massachusetts patients are MassHealth members. Hospital officials said the significant Medicaid cuts would produce financial aftershocks that would affect all patients in the hospital.
“The dangers of children's hospitals in Japan, [if] We will begin cutting Medicaid and will impact the delivery of care for all patients,” said Joshua Greenberg, Vice President of Government Relations for Boston Children.
On Monday, Gov. Maura Healy and her partner Joanna Ridgate toured the children to highlight the potential Medicaid cuts and the suspension of millions of grants from the National Institute of Health could impact patients. Hospital president and CEO Kevin B. Churchwell said cuts in federal funding have already disrupt clinical trials and research, including vaccine jobs.
“This is why we have patients in clinical trials where treatment has stopped,” Healy said. “Can you imagine the cruelty of that?”
Among Medicaid-backed groups, including seniors and people with disabilities, children are relatively inexpensive customers. They account for about 16% of the state's total mass patient costs. Some registered families of children also have private insurance, but they rely on MassHealth for secondary coverage to support medical bills that the insurance company does not cover.
For many children, MassHealth membership means more than a covered doctor visit. The program pays for anything needed to ensure that children with disabilities have the equipment, care and support they need. This allows children to receive Medicaid-covered services through school health services and pay for behavioral care in the community and at home.
Plus, MassHealth's family Get a screen to identify dental, hearing, vision, or developmental concerns. Such widespread and widely accessible insurance coverage can benefit your children's lifetimes. Children with excellent health care will get better at school. Reports listedand those with access to Medicaid tend to do so In adulthood, there are fewer hospital stays, emergency room visits, and chronic illnesses.
Laura Libuditis, a doctor at Victoria Bernard, director of pediatrics at Mattapan Community Health Center, said about 90% of children treated at the center are registered with MassHealth. Most of her patients come from families living below the poverty line. MassHealth's broad coverage helped them avoid evictions, she said. And for immigration, the program has They helped them connect to ensure stable food and housing.
“I was constantly impressed with the breadth and depth of service for patients,” Livaditis said. “I don't remember the last time I had to fight [MassHealth] Insurance for the services you need. ”
Correspondent Emily Spatz contributed to this report.
Jason Laughlin can be contacted at jason.laughtin@globe.com. Follow him @JasmLaughlin.
